How to respond to gun shot wounds emergency situations

GSW Emergency Care Essentials

The call from a FOX producer asking for help was my first clue. But when I got the Twitter alert that @JoseConsecosFinger started following me, I knew this was a real story. Seems former Major League Baseball outfielder Jose Canseco had a handgun mishap and the scuttlebutt had already got to the national press.

Canseco, now a resident of Las Vegas, was apparently cleaning his Remington .45 when it discharged. In an amateur move Canseco assumed the weapon was empty. He's lucky not to have killed himself or his fiancee who was home with him at the time.

Notwithstanding the jokes or the fact that @JoseConsecosFinger has no attachment to the real athlete, few weapons wield the unforgivable fury of a firearm. Even a small caliber gun in the hands of the inexperienced can maim or kill.

Firearm Safety is the cardinal rule when it comes to firearms and unless they're drawn for competition, target practice, cleaning, hunting or self-protection, they should be holstered or otherwise secured. In the real world, however, there will always be situations where equipment fails or misfires, accidents occur, and yes, the wrong people get a hold of a weapon. There are plenty people who show us what not to do with firearms on a daily basis.

Emergency preparation should be a fundamental aspect of your kit and that includes first aid items, investing in emergency training and developing contingency plans in advance of an emergency.

Don Abshier is Fire Training Officer for Nevada's largest fire service, the Clark County Fire Department. He trains the department's paramedics and EMTs who not only responds to emergencies on the Las Vegas Strip, but the larger surrounding community including rural area used frequently for target shooting and hunting.

“I'd say the bulk of GSWs (gunshot wounds) happen in the urban areas and are usually the result of gangs or criminal activities, but when we respond to an unintentional GSW, it's usually in the home or out in the desert where people are target practicing or hunting,” says Abshier.

Pistols, rifles, and high-powered rifles are ultimately designed to kill, but there are differences in how they act when they strike the human body with pistols affording the greatest chance of survival when discharged accidentally. Most intentional and unintentional shootings occur in close proximity and their outcome potential (notwithstanding user ability) relies upon three factors with: The area of the body struck, the speed or velocity of the projectile, and the distance between discharge and impact.

It is possible to survive a pistol shot point blank range because bullets create trauma by tumbling (also known as yaw or precession), expanding and fragmenting.

If a bullet meets little or no resistance like that of the skin and fat or soft tissue, it can theoretically sail through the body missing vital organs and veins. If, however, the bullet hits bone and splinters it, it can create mini projectiles that will further tear into flesh or organs.

When a vital organ or artery is torn, it bleeds. Bleeding can lead to death in as little as one minute and that's not much time to do anything but activate the emergency response system and get the victim to the trauma center.

1. Call 911.

Once 911 is activated, make sure the victim is safe. If it's an active range, make sure others are alerted to cease fire. Do not move the victim more than is necessary.

2. Check Airway, Breathing, Circulation.

Visually assess the victim's overall condition while talking to them in a calming manner. According to Abshier, “Sometimes the only and best thing you can do for someone critically injured, is hold their hand.”

Assess the ABCs or Airway, Breathing and Circulation. If the victim is breathing and/or can talk, tend to the profuse bleeding immediately. Slow or stanch bleeding by applying direct pressure (using your hand and a bandage, heavy clothing or simply your hand).

3. Squeeze me?

Wounds to the leg or arm may require a tourniquet. Apply it above the area that is bleeding. If you do not have a tourniquet, improvise and use a belt or scarf. Secure the tourniquet snuggly and once placed, do NOT check to see if bleeding persists.

4. Pressure, please.

If the victim is wounded on the trunk or body, use direct pressure preferably using a bandage. If the bleeding soaks the bandage, simply apply more bandage on top of the old one. Do NOT remove the initial bandages and keep pressure on until EMS arrives.

5. Chest wounds suck.

Through-and-through wounds to the chest may benefit by the use of an occlusal dressing on both the entrance and exit wound especially if the victim complains of shortness of breath on the affected side.

6. Keep calm and warm while waiting.

Keep the victim comfortable and warm using a thermal blanket or clothing to cover them. It may seem like hours, but chances are EMS will arrive within minutes even if they're landing a helo.

Crisis isn't an “if,” it's a “when,” and no matter how well you might perform under pressure, an unintentional gunshot wound can buckle the knees of the strongest men. “I've seen grown men cry like hysterical babies,” says Abshier, “No one really knows how they'll respond in a crisis, but having a plan in advance will help reduce additional stress and ensure the best outcome in the worst scenario.”


The Center for Wilderness Safety
National Registry of Emergency Medical Technicians


Sharon Chayr  

About The Author


Sharon Chayra is an award-winning writer and producer whose work has appeared in national newspapers, magazines, books and TV. She is the founder of ChayraComm, a PR firm serving select clients in the firearms, TacMed, military and non-profit organization sectors. Chayra is well-acquainted with duty given her and her family's distinguished heritage in the military, law enforcement, EMS and fire services.